Post- and pre-Valsalva pulse pressure gradient as a marker of left ventricle systolic dysfunction

Fernando Iván Vergara-Orduña; David Dávila-Sosa; Daniel Benítez-Maldonado; José Ricardo Garrido-García; Germán Vargas-Ayala; Norma Laura Fonseca-Tinoco; Miriam Marcela Hernández-Sánchez; Elizabeth Palacios-Pérez; Fernando Iván Vergara-Orduña; David Dávila-Sosa; Daniel Benítez-Maldonado; José Ricardo Garrido-García; Germán Vargas-Ayala; Norma Laura Fonseca-Tinoco; Miriam Marcela Hernández-Sánchez; Elizabeth Palacios-Pérez

2019, Number 5

Med Int Mex 2019; 35 (5)

Post- and pre-Valsalva pulse pressure gradient as a marker of left ventricle systolic dysfunction

Vergara-Orduña FI, Dávila-Sosa D, Benítez-Maldonado D, Garrido-García JR, Vargas-Ayala G, Fonseca-Tinoco NL, Hernández-Sánchez MM, Palacios-Pérez E, Vergara-Orduña FI, Dávila-Sosa D, Benítez-Maldonado D, Garrido-García JR, Vargas-Ayala G, Fonseca-Tinoco NL, Hernández-Sánchez MM, Palacios-Pérez E

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ABSTRACT

Background: Heart failure affects to 26 million people worldwide. The variation of the blood pressure and heart rate values after performing the Valsalva maneuver has been evaluated, finding a correlation between left ventricular function and natriuretic atrial peptide.
Objective: To determine if post- and pre-Valsalva pulse pressure gradient is useful as marker of left ventricle systolic dysfunction.
Material and Method: A cohort study was done from January 1st to June 30, 2017, determining left ventricular ejection fraction, cerebral natriuretic peptide, as well as the subtraction of post-Valsalva and pre-Valsalva pulse pressure, this variable was determined as pulse pressure gradient.
Results: There were included 32 patients. A gradient figure of less than 4.22 had a negative correlation with a left ventricular ejection fraction lesser than 50%, with a correlation coefficient of -0.562 and a p value of 0.001, in addition to having an area under the curve of 0.71.
Conclusions: The gradient and the ejection fraction had a negative correlation, this in the indeterminate area of the systolic function. An LVEF lesser than 50% implies risk of decompensation and a depressed LVEF.

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